Goodwin M J
School of Engineering, Staffordshire University, Beaconside, UK.
Med Eng Phys. 1994 Jul;16(4):267-72. doi: 10.1016/1350-4533(94)90049-3.
In patients with lung disorders there is often a build up of mucus inside the lungs which in healthy people is normally removed by the action of cilia on the lung tissue surfaces. In the diseased lung, however, this clearance mechanism may be ineffective and so patients are offered physiotherapy in order to assist the mucus removal process. The consequences of not properly removing the mucus are impaired lung function and a much higher risk of contracting lung infections and suffering consequent permanent scarring of the lung tissues. If unchecked the latter leads ultimately to failure of the lungs and to the patient's death. The most common forms of chest physiotherapy used are percussion coupled with postural drainage and an active cycle of breathing. This requires the patient to lie head downwards on an inclined surface, so that gravity might assist the mucus removal process, whilst the physiotherapist strikes the patient's chest with the hands. The procedure is interspaced by periods of 'huffing and coughing' by the patient to remove the loosened sputum from the body. An alternative to the manual percussion described above is to use machinery to provide the stimulus to the chest. If such a procedure were found to be satisfactory then it would enable more patients to manage their own physiotherapy, may make the required duration of the physiotherapy sessions shorter, and would free much of the professional physiotherapists' time to enable them to assume more of a physiotherapy management role.(ABSTRACT TRUNCATED AT 250 WORDS)
患有肺部疾病的患者肺部常常会积聚黏液,而在健康人身上,这些黏液通常会通过肺组织表面纤毛的作用被清除。然而,在患病的肺部,这种清除机制可能会失效,因此会为患者提供物理治疗,以协助黏液清除过程。不能正确清除黏液的后果是肺功能受损,以及感染肺部疾病并随之导致肺组织永久性瘢痕形成的风险大大增加。如果不加以控制,后者最终会导致肺功能衰竭和患者死亡。最常用的胸部物理治疗形式是叩击配合体位引流和主动呼吸循环。这要求患者头朝下躺在倾斜的表面上,以便重力有助于黏液清除过程,同时物理治疗师用手拍打患者的胸部。该过程会穿插患者的“哈气和咳嗽”阶段,以将松动的痰液排出体外。上述手动叩击的替代方法是使用机器对胸部提供刺激。如果发现这样的程序令人满意,那么它将使更多患者能够自行进行物理治疗,可能会缩短所需的物理治疗疗程,并将释放大量专业物理治疗师的时间,使他们能够承担更多的物理治疗管理职责。(摘要截断于250字)